CPT 48545 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 11 - Office • 23 - Emergency Room |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 51 - Multiple procedures |
| Complexity Level | High |
| CMS | $1,314.89 Physician Fee Schedule |
National average reimbursement for CPT 48545 by major payers:
$1,717.63
$1,772.55
$1,846.66
$2,170.96
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 48545 | ||||||
United | 48545 | $397.00 | 1033760723 - ADVANCED SURGERY CENTER OF OXFORD | 825522826 - (FL) OXFORD SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $90.00 | 1528009453 - TGLP, LP, THE ENDOSCOPY CENTER OF TEXARKANA | 201584968 - (TX) TGLP LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $1416.00 | 1619979580 - PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER PORT ORANGE | 201388947 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $1344.00 | 1891701611 - ESSEX ENDOSCOPY CENTER LLC | 223777761 - (NJ) ESSEX ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $822.00 | 1073682159 - CENTRAL MASSACHUSETTS AMBULATORY ENDOSCOPY CENTER LLC | 830375714 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $429.00 | 1316919574 - CHEVY CHASE ASC LLC, CHEVY CHASE ENDOSCOPY CENTER | 621666144 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $743.00 | 1699327734 - KS SC LLC, KELSEY-SEYBOLD CLINIC AMBULATORY SURGERY CENTER | 842241460 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $375.00 | 1437691177 - FRESENIUS VASCULAR CARE CINCINNATI ASC LLC, AZURA SURGERY CENTER CINCINNATI | 814225843 - (OH) FRESENIUS VASCULAR CARE CINCINNATI ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $1133.00 | 1366521643 - MEDICAL AMBULATORY SURGICAL SUITES LLP, KIRBY SURGICAL CENTER | 680550412 - (TX) KIRBY SURGICAL CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $840.00 | 1386821817 - MIAMI SURGERY CENTER LLC, SURGERY CENTER AT DORAL | 364600281 - (FL) MIAMI SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $470.00 | 1265519821 - SEVEN HILLS SURGERY CENTER LLC | 203044042 - SEVEN HILLS SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $315.00 | 1720081664 - HEATON LASER AND SURGERY CENTER L L C | 752752100 - (TX) HEATON LASER AND SURGERY CENTER L L C | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $376.00 | 1740413400 - ATLANTIC SURGERY & LASER CENTER LLC | 262041000 - (FL) ATLANTIC SURGERY LASER CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $658.00 | 1346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP | 593346125 - (FL) LAKELAND SURGICAL AND DIAGNOSTIC CENTER LLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48545 | $300.00 | 1518922541 - VISION SURGICAL CENTER AT SPRINGHILL PSC | 352100428 - (IN) VISION SURGICAL CENTER AT SPRINGHILL PSC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 48545 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48545 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 48545 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 47800-CPT | High | Reconst Exthepatic Ducts W Anastomo |
| 48152-CPT | High | Pancreatectomy, Proximal Subtotal With Total Duodenectomy, Partial Gastrectomy, Choledochoenterostomy And Gastrojejunostomy (Whipple-Type Procedure); Without Pancreatojejunostomy |
| 48545-CPT | High | Pancreatorraphy For Trauma |
| 48547-CPT | High | Duodenal Exclusion With Gastrojejunostomy For Pancreatic Trauma |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48545. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48545 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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